Relative Entitlements: Reckoning Recipients’ Access to Publicly-funded Assisted Reproductive Technologies (ARTs) Cultural Understandings of Kinship and Gender in Quebec (Canada)

Between August 2010 to November 2015, Quebec was the only jurisdiction in North America to fund assisted reproductive technologies (ARTs). This government financing was comprehensive. It provided three rounds of in vitro fertilization along with a host of other fertility treatments and medications. Though public funding removed economic constraints to ART usage, not everyone gained equal access. This followed from regulatory gaps, which set the stage for uneven access among recipients. Recipients experienced processes of inclusion or exclusion, which unfolded in keeping with cultural ideas concerning kinship and gender. Kinship and gender were meaningful in the way recipients were recognized as being more or less “worthy” of reproducing than others. This corresponded with new forms of stratified reproduction that redefined reproductive autonomy. This dissertation will focus on those who were most recognizably in need of public ARTs, such as heterosexual and same-sex couples (in particular lesbians). It will also follow those who were pushed aside: women with advanced maternal age, single women, and women deemed to have a high body mass. Among all these recipients, ART access entailed paradoxes tied to kinship and gender. Inevitably, this caused some recipients to be considered more “worthy” than others of public ARTs. Public ARTs might have been used in novel ways, but my work will show reproductive possibilities often replicated comprehensible kinship and gender relations. Financial means remained an index of who was seen as a worthy recipient and deserved to have a family. Gay and lesbian ART access was conditional and tied to family law and financial means. Women's age, social status, and body mass were troubling conditions of exclusion. Moreover, contrary to the program’s aims, public ARTs encouraged an already robust ART market. Based on participant observation at three clinical sites in Montreal (Quebec) between 2011 and 2013, and over 100 interviews with patients and a small group of providers, I will illustrate how ART access and availability is a contested arena that (re)produces kinship and gender relations in certain ways. This shows that access is much more complex than whether the state decides to fund ARTs.Ph.D